Unrecognized Diabetes Common in Acute MI Patients
(HealthDay News) — One in 10 acute myocardial infarction (AMI) patients without a previous diagnosis of diabetes mellitus (DM) have underlying DM, according to research published online April 21 in Circulation: Cardiovascular Quality and Outcomes.
Suzanne V. Arnold, MD, MHA, from Saint Luke's Mid America Heart Institute in Kansas City, MO, and colleagues reported on the incidence of new DM and its recognition among patients with AMI. Data were included for patients in a 24-site U.S. AMI registry from 2005–2008.
The researchers found that 10% of the 2,854 AMI patients without known DM on admission met criteria for previously unknown DM, defined by a core laboratory glycosylated hemoglobin of ≥6.5%. Sixty-five percent of these cases were unrecognized by treating clinicians, and had not received DM education, glucose-lowering medications at discharge, or documentation of DM in the chart. At six months after discharge, initiation on glucose-lowering medications occurred in 5% of those not recognized as having DM during hospitalization, compared to 66% of those recognized as having DM (P<0.001).
"Underlying DM that has not been previously diagnosed is common among AMI patients, affecting one in 10 patients, yet is recognized by the care team only one-third of the time," the authors write. "Given its frequency and therapeutic implications, including but extending beyond the initiation of glucose-lowering treatment, consideration should be given to screening all AMI patients for DM during hospitalization."
Several authors disclosed financial ties to the pharmaceutical and health care industries.